Understanding Anesthesiology - The Global Regional Anesthesia ...

Bacterial endocarditis
The 2007 American Heart Association (AHA) Guidelines for the prevention of bacterial endocarditis
recommend antibiotic prophylaxis only for patients with certain cardiac conditions
undergoing certain surgical procedures.
The relevant procedures are listed below:
1) dental procedures involving manipulation of the gums or the roots of the teeth.
2) procedures of the respiratory tract.
3) procedures involving infected tissues.
Interestingly, procedures of the genitourinary or gastrointestinal tract do not indicate prophylaxis,
assuming uninfected tissue.
The relevant cardiac conditions are listed below:
1) patients with artificial heart valves.
2) patients who have had heart repairs using prosthetic material. This does not refer to coronary
stents.
3) patients with a prior history of endocarditis.
4) patients with certain un-repaired or incompletely repaired congenital heart disease.
5) patients who have transplanted hearts who now have developed a heart valve problem.
Prophylaxis is required when a patient with one of the above conditions is undergoing
one of the above-described surgical procedures.
Updates to these recommendations are readily available online.
Related Glossary Terms
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Chapter 2 - Pre-operative Evaluation